Pharm Justice Enoma writes: DRUGS AND PREGNANCY

DRUGS AND PREGNANCY

A woman walks into a near by drug store and makes a complaint to the owner of the shop “madam I feel feverish, I have headache and body pain and I vomited in the morning. The woman did not hesitate to go to her shelf and bring out an Artemesinin combination therapy drug for the lady. She was healed after 3 days and sang praises to the owner of the drug store, but little did she know that 8 months later she will give birth to a deformed baby.

Patient M, was 3 months pregnant but she had diarrhea she was stooling and she needed an intervention. Getting  to a drug store she made a complaint to the owner of the drug store who gave her a combination of drugs containing tetracycline and ciprofloxacin to effectively take care of the micro organism that was responsible for the case. Mrs modupe gave birth to a baby girl Kemi who was very beautiful but had a single flaw which was her teeth. Kemi  in all her beauty as a child had discolored teeth.

pregnancy or the gestation period is a very fragile and complicated time for the female anatomy. The mother and the unborn foetus are connected in ways beyond what the lay man imagines. They share a common circulation. The mother is connected to the child by virtue of the placenta and it is an organ that connects the developing fetus to the uterine wall to allow nutrient uptake, waste elimination, thermo-regulation and gas exchange via the mothers blood supply. The placenta attaches to the wall of the uterus, and the baby’s umbilica cord develops from the placenta.

Although once thought to be a barrier to drug transfer the placenta is a medium of transfer of a number of substances between the mother and foetus especially drugs and the placenta functions fully for such transport by the fifth week of conception. Drugs which albeit were of no harm to the mother posse significant treats to the developing foetus. Most of these so called drugs could cause physical or functional deformites to the foetus these drugs are called teratogens. The degree to which exposure to a drug influence s the embryo/fetus also maybe a function of the timing of the exposure. Drug exposure using the embryonic period (period between fertilisation and 10th weeks of gestation) has the greatest potential influence on organ development. Indeed, the most obvious teratogenic effects occur during this period. Teratogenic effects may include,

• Loss of pregnancy
• Structural abnormalities 
• Growth impairment 
• Functional loss

However more subtle change in function and behaviour  may be associated with drug exposure at other times during pregnancy

Thus care is paramount when pregnant patients are prescribed or dispensed to. Some of the common drugs which posse a potential hazard to the developing foetus includes

NSAIDS (Non-steroidal anti-inflammatory drugs) : Children whose mothers use the pain reliever during pregnancy may be at risk for asthma, behavior problems and attention deficit disorder according to preliminary reports. For women who use Paracetamol the risk to the foetus is quite small

Simvastatin and other statins : Cholesterolis needed for the growth of the foetus and its reduction by statins could harm the foetus

Oral Contraceptives : they can cause birth defects

Dutasteride : affects the sex organ development of the male fetus

Tetracycline : it gets deposited in fetal bones and retard their growth, also affect teeth causing them to be discolored and deformed

Chloramphenicol : Grey Baby Syndrome

ACE Inhibitors : Growth retardation, Birth defects and Fetal Death
During the last 3 months of pregnancy, drugs crossing the placental barrier may interfere with the vital functions of the fetus e.g. sulphonamides which may increase bilirubin levels leading to kernicterus (fetal jaundice), or morphine which when given to the mother during labor can cause fetal asphyxia, etc
In conclusion to the above certain tips that must be considered before taking a drug during pregnancy include :

Try non drug measures

Consult your healthcare provider

Avoid combination products

Read labels
                                   Thank you

Enoma Justice
600 Level pharmacy student
University Of Benin

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